Abstract

Background & Purpose: Long term cognitive deficits among pediatric stroke survivors have a significant impact on quality of life and long term functional outcome. The degree to which age at stroke relates to cognitive outcome is not clear, with some literature suggesting that younger age at stroke results in worse cognitive outcome. The present study investigated the impact of age at stroke on cognitive outcome measured by IQ in a pediatric sample with mixed stroke etiology.

Methods: Subjects were 47 children (62% male) with mixed stroke etiology including sickle cell disease (23%), cardiac disease (15%), vascular disease (17%), and traumatic injury (11%) who were seen for neuropsychological evaluation as part of long-term clinical care, at which time an IQ score was obtained. Age at stroke, location, and etiology were gathered from records and considered for analysis.

Results: Mean IQ for the sample was 83.68, although scores ranged from 45 to 121. There was a significant correlation between IQ and age at stroke (r = .290, p = .048), with younger age at stroke associated with lower IQ. When males and females were studied separately, this correlation was not significant for males (r = .305, p = .106) but was significant for females (r = .612, p = .007). A simultaneous linear regression model including age at stroke, gender, etiology, and stroke location significantly predicted variance in IQ (R = .543, F = 4.382, p = .005). Age at stroke and gender were the only two predictors that significantly contributed to the model.

Conclusions: We found a significant correlation between stroke age and IQ, with younger stroke age associated with lower IQ. Results suggest a possible gender difference, with females in our sample more vulnerable to lower IQ as a function of younger age at stroke. Combining stroke age, gender, etiology, and stroke location accounted for a significant amount of IQ variance. Further research is necessary to clarify factors associated with outcome in survivors of pediatric stroke and should include factors such as stroke severity and socioeconomic status. Improved understanding of factors associated with cognitive outcome following pediatric stroke may inform clinical management to hopefully improve cognitive outcomes and quality of life in this population.